Central venous catheters as a vascular access modality for pediatric hemodialysis |
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Authors: | Fatina Ibrahim Fadel Hesham Nabil Abdel Mooty Hafez Mahmoud Bazaraa Samar Mohamed Sabry |
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Institution: | (1) Pediatrics Department, Center of Pediatric Nephrology and Transplantation, Faculty of Medicine, Cairo University, Giza, Egypt;(2) Surgery Department, Center of Pediatric Nephrology and Transplantation, Faculty of Medicine, Cairo University, Giza, Egypt;(3) Present address: 148 Tahrir St #802, Dokki, Giza, Egypt |
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Abstract: | Background The use of hemodialysis catheters is an essential component of dialysis practice. Children are particularly likely to require
multiple courses of dialysis over their lifetime, hence the repeated need for vascular access. These catheters remain a significant
source of morbidity and mortality.
Methods All catheters inserted for hemodialysis at the Center of Pediatric Nephrology and Transplantation, Cairo University over a
period of 40 months were studied. Patient data as well as data of catheter insertion, dwell, cause of removal and complications
were reported.
Results A total of 195 uncuffed central venous catheters were used for temporary access in 131 patients for a mean duration of 35.7 days.
Of attempted insertions, 87.4% achieved successful access, of which 56% remained for the required period, 8.9% were accidentally
dislodged, and 35.1% were removed due to complications—mostly infection. The overall rate of possible catheter-related bacteremia
was 9.6 episodes/ 1,000 catheter days. Infection increased with longer catheter dwell. Nineteen cuffed tunneled catheters
were surgically inserted and used for up to 11 months (mean 117 days). Loss of these catheters was attributed mainly to infection
(ten episodes) and catheter thrombosis (six episodes). During the study, 317 femoral catheters were inserted.
Conclusion Uncuffed central venous catheters are both needed and useful for short-term hemodialysis. Vascular access for extended durations
may be provided by cuffed tunneled catheters. Infection is the major serious concern with both uncuffed and cuffed catheters. |
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Keywords: | Catheter-related bacteremia Catheter survival Long-term catheters Renal failure Temporary hemodialysis catheters |
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